Commerce City (aka Combat Shitty) is an industrial area of Denver where there are a lot of poor and working poor. There's a lot of violence and chances for industrial accidents. It's one of the places you go if you want to see trauma calls and gunshot wounds.
That's not all you see there, though.
Sometimes you get a call out to one of the little trailer parks, because people do live here even though no one really wants to, and it's for chest pains, possible heart attack. It's an older man in a uniform (you decide what kind) pale and sweaty and shaking, his face like dough. He's got a crocheted afghan in a startling color combination covering his lap, and his wife (you guess she's the one who made it, she's got that look) wrings her hands nearby. She's the one that called you. He's as mad as he can manage when he can barely breathe.
The paramedic hooks up the EKG.You don't know how to read the bouncing lines, but even you know it's not good. Okay, let's go. We need to get you to the hospital.
You're probably having a heart attack. This could kill you. You need to come with us.
"No. It's too expensive. I can't."
He's got kids, and grandkids, and too much debt already. That's what he tells you. And you try to tell him that life is worth a hell of a lot more than money. Grandkids, right? You want to play with your grandkids.
"I don't want them to pay my bills."1
Your paramedic calls the hospital and has one of the ER docs talk to the man, try to scare him or cajole him into coming along. The sick man's wife wrings her hands some more, rubs his shoulders, but she doesn't argue with him, doesn't help us. She's in the shadow of that same specter.
And that's all you can do, in the end. You can argue, cajole, even threaten a little, and it doesn't matter. The man knows who he is, where he is, when it is (that's called AAOx3) and he has the right to refuse your help, by law
So you pack up your things and walk, really slowly, to the door. You drive away so slowly that cars honk at you. Because you're hoping, you're goddamn hoping that poor man will collapse while you're still only a couple miles from his trailer, and his wife will call you, and you can come screaming back and save his life whether he wants you to or not, like you're some kind of goddamn hero.
This happens every goddamn day. Heart attacks and car accidents and sickness, and they won't go because they're so fucking scared of debt collectors harassing them, harassing their families. This is one of the reasons I stopped being an EMT. I couldn't handle seeing people kill themselves like this any more, because I want to believe we live in a world where life is still more important than money. I couldn't handle feeling complicit and responsible for someone's life when they had to make a shitty, impossible decision like that.
So yeah, maybe people without insurance don't get thrown out of the doors of an ER to bleed out in the snow. I guess that's the image Mitt Romney is going for because it sounds incredibly ridiculous.
“We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack,’ ” he said as he offered more hints as to what he would put in place of “Obamacare,” which he has pledged to repeal.We do have people who die in their apartments (or trailers, or houses, or by the side of the road) because they lack insurance. But it's not necessarily because no one will take them. It's because they won't fucking go in the first place, because suicide is cheaper. Because if you're going to die, it's better to not leave your already grieving family drowning in debt and destroying what pride they have left in searching for charity that may never materialize.
“No, you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital. We don’t have people that become ill, who die in their apartment because they don’t have insurance.”
Every goddamn day.
1 - Debt collectors can't legally go after anyone but spouses (and in some states not even that) in a case like this, unless it was the kids/grandkids that signed the hospital admissions. This does not stop unscrupulous debt collection agencies from trying however, and many people do not understand their legal rights. (Also, families can be put in the position of supporting the person who is trying to pay the debt, which is a whole other ball of wax.)